There are few diagnoses that cause more fear and anxiety than dementia. The idea of losing your mind – the very thing that defines each of us as individuals – is incredibly frightening.
I have seen countless cases of dementia in my 36 years as a doctor. It is excruciating to watch a patient’s cognitive abilities gradually decline. The number of people suffering from dementia worldwide was estimated at 57 million in 2019. By 2050, this number is expected to rise to 153 million. It would be in the interest of all of us to find ways to prevent dementia.
The best way to prevent dementia is obvious and unhelpful: don’t grow old. Other variables are not so easy to manipulate. For example, people born female have a higher risk of age-related dementia, although part of this figure may be due to the generally lower educational attainment of women worldwide.
Aside from not aging, there is a considerable amount of research on the preventable causes of dementia. On July 31, the British medical journal The Lancet published its 2024 update on dementia and identified 14 variables that can reduce dementia risk by up to 45 percent (thelancet.com/journals/lancet/article/PIIS0140-6736(24)01296-0/abstract ). Some of these may seem obvious, like living healthier and staying active. Others are not so obvious.
Risk Factors for Dimensia by Amy Paige Condon on Scribd
The idea of cognitive reserve plays a role in determining a person’s resilience to dementia. Simply put, healthier people can resist neuropathologies better than those who are not as healthy. A defined and unavoidable age-related loss of memory and cognitive function affects us all. No older person can think as quickly or remember facts as well as they did when they were younger. These losses in cognitive function are directly related to certain age-related structural changes in the brain, some of which are visible on CT or MRI: atrophy, microinfacts (pin marks), neuritic plaques, etc. Since some age-related dementia is vascular in origin, it stands to reason that some neurovascular dementias may be preventable by better controlling the variables that contribute to vascular injury.
Similarly, variables that keep people cognitively engaged in the world can maintain higher brain functions even in the face of structural deterioration. In this sense, vision and hearing loss, as well as lack of social and intellectual stimulation, almost certainly play a crucial role in the likelihood of developing dementia. Here, the saying “if you don’t use it, you lose it” applies. In general, elements that reduce vascular damage, reduce dementia neuropathy, reduce inflammation, and build cognitive and mental reserves are helpful in reducing the risk of dementia.
According to The Lancet, the following variables can influence the development of dementia:
Early life:
Middle age:
Later life:
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Social isolation (5%)
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Air pollution (3%)
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Vision loss (2%)
Some important points here:
First, there is clear evidence that people who are healthier overall are more resilient to dementia. A Chinese study showed that four of the following six variables reduce the risk of dementia: healthy diet, active social contacts, regular exercise, regular cognitive stimulation, not smoking and not drinking too much alcohol.
These variables make sense because avoiding things that negatively impact overall health, whether by reducing inflammation or increasing the risk of brain injury, is essential to preventing dementia. Since high cholesterol, uncontrolled blood pressure, tobacco use, and obesity all contribute to vascular injury, positively manipulating all of these factors may reduce dementia risk. Excessive alcohol consumption (more than one glass of wine per day) has direct neurotoxic effects on the brain and increases dementia risk.
Second, it is important to remain socially and intellectually active. For example, there is a direct and linear relationship between hearing loss and dementia risk, and the use of a hearing aid has been shown to prevent dementia progression. Education level plays a role. Social isolation and depression increase the risk of dementia, as does visual impairment. All of these factors can be addressed and/or prevented.
In Europe and North America, the risk of developing dementia has fallen by 25% over the past 20 years, even when taking into account the ageing population. This would not have been possible without improving the environmental variables that influence the development and progression of dementia. However, as the world’s population ages, the global prevalence of dementia will increase. Understanding the elements that can help prevent dementia in all of us – and that is something that will be beneficial for everyone.
This article originally appeared in the Savannah Morning News: Risk factors for developing dementia
